Agenesis of the internal carotid artery: Color Doppler, CT, and MR angiography findings

Sliwka, Ulrich; Schmidt, Peter Koerver; Reul, Jürgen; Noth, Johannes

doi:10.1002/(sici)1097-0096(199805)26:4<213::aid-jcu7>3.0.co;2-g

Cited by 16 publications

(11 citation statements)

References 3 publications

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“…Sonographic findings suggestive of ICA agenesis include nonvisualization of the the carotid bifurcation, ipsilateral hypoplasia of the CCA, and a normal ipsilateral CCA Doppler waveform [1, 4]. At DSA, nonvisualization of the ICA shortly after its origin and an enlarged ECA may be seen [5].…”

Section: Discussionmentioning

confidence: 99%

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An Important Clue in the Sonographic Diagnosis of Internal Carotid Artery Agenesis: Ipsilateral Common Carotid Artery Hypoplasia

Kaya

Yılmaz

Gülek

et al. 2014

Case Reports in Radiology

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A 42-year-old female patient, who had been diagnosed with an occlusion of her left internal carotid artery (ICA) following Doppler ultrasonographic (US) and digitally-subtracted angiographic (DSA) examinations performed in an outer healthcare center in order to eliminate the underlying cause of her complaint of amorosis fugax, later applied to our hospital with the same complaint. At Doppler US performed in our hospital's radiology department, her right common carotid artery (CCA) was normal, but her left CCA was hypoplastic. The right internal artery (ICA) was validated as normal. At the left side, however, the ICA was apparent only as a stump and it did not demonstrate a continuity. The diagnosis of ICA agenesis was confirmed by the utilization of Doppler US, CT, and DSA imaging, and it was concluded also that ipsilateral CCA hypoplasia could be evaluated as an important clue to the diagnosis of ICA agenesis.

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Section: Discussionmentioning

confidence: 99%

“…An ICA agenesis may be misdiagnosed as an occlusion as was in our case [4]. In the setting of a differential diagnosis in ICA occlusion, the imaging of the skull base and the investigation of the presence of the carotid canal are mandatory [2].…”

Section: Discussionmentioning

confidence: 99%

An Important Clue in the Sonographic Diagnosis of Internal Carotid Artery Agenesis: Ipsilateral Common Carotid Artery Hypoplasia

Kaya

Yılmaz

Gülek

et al. 2014

Case Reports in Radiology

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“…By the presence of a patent but very reduced vascular lumen, hypoplasia is distinguished from aplasia which is associated with vestiges of non-patent vessels and from agenesis which implies complete absence of development of the vessel. The mechanism of development of hypoplasia of the ICA is unclear: Some authors have suggested secondary regression of the ICA following a phase of normal development, whereas others consider it to represent arrest of the development of the ICA, at a given moment in time [8]. In the literature there is no clear association between ICA hypoplasia and cerebral ischemia, due to the development of collateral vessels and variations of the circle of Willis to accommodate the diminished carotid flow [2,8,9].…”

Section: Discussionmentioning

confidence: 99%

“…In the majority of patients with ICA hypoplasia, collateral circulation to the intracranial arteries is from the contralateral ICA and the vertebrobasilar system via the circle of Willis [1,2,8]. In case 1 the only variation was hypoplasia of the left A1 segment of the ACA, the left A2 segment being supplied by contralateral A1 segment.…”

Section: Discussionmentioning

confidence: 99%

“…The reason for this is that the early development of the ICA in the fourth embryonic week is necessary for the ICA canal in the bone of the skull to develop in the fifth to sixth weeks of fetal life [8]. As a consequence, demonstration of a small carotid canal, which is very easy with CT of the skull base, is an essential argument in favor of this congenital condition.…”

Section: Discussionmentioning

confidence: 99%

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Hypoplasia of the internal carotid artery: a noninvasive diagnosis

et al. 2000

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We present the characteristic imaging findings of hypoplasia of the internal carotid artery (ICA) in two cases, one accompanied by an intracranial aneurysm. Finding of a diffuse luminal narrowing of the ICA on MR angiography or digital subtraction angiography (DSA) could wrongly evoke severe acquired diseases such as dissection or atherosclerosis. Absence of associated wall thickening and flow disturbances on color Doppler sonography (CDS) should suggest carotid hypoplasia. Confirmation of the diagnosis is obtained by CT of the skull showing a small carotid canal. Non-invasive procedures are sufficient to differentiate this rare congenital anomaly from acquired string signs.

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Application and diagnostic points of carotid artery ultrasound in the detection of internal carotid artery absence: Analysis of 16 cases and literature review

Cheng,

Liu,

et al. 2024

J of Clinical Ultrasound

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ObjectiveTo summarize the ultrasound diagnostic key points and imaging characteristics of absence of the internal carotid artery (ICA), and to explore the application value of carotid artery ultrasound in the diagnosis of ICA absence.MethodsSixteen patients diagnosed with ICA absence at our hospital were retrospectively analyzed. Clinical data, ultrasound images, and other relevant imaging data were reviewed. The ultrasound diagnostic key points and related imaging characteristics of ICA absence were summarized. Combined with a literature review, the application of carotid artery ultrasound in the diagnosis of ICA absence was discussed.ResultsAmong the 16 patients, there were 10 males and 6 females ages ranging from 13 to 80 years. Among them, 5 patients had a history of cerebral infarction, 1 patient had a history of subarachnoid hemorrhage, and 10 patients had no history of stroke. Among the 16 patients, there were 10 left‐sided lesions, 5 right‐sided lesions, and 1 bilateral lesion. Three patients had concomitant aneurysms. Carotid ultrasound examinations in all 16 ICA absent patients revealed that a significantly slender common carotid artery (CCA) diameter compared to the contralateral (3.91 ± 0.73 vs. 6.92 ± 1.42, p < 0.001). On the side of ICA absence, the bifurcation of the carotid artery was not detected, with the CCA directly continuing as a single artery (external carotid artery, ECA). The temporal superficial artery percussion test was positive in all cases, and the blood flow spectrum of the single artery (ECA) on the side of the absent ICA showed a serrated pattern during diastole. On the side where the ICA was absent, the blood flow spectrum morphology of the CCA and ECA was consistent. Based on other relevant imaging examinations, the patients were classified into Lie types: A (10 cases), B (2 cases), C (1 case), D (1 case), and 2 cases were unclassified.ConclusionCarotid artery ultrasound has the advantages of easy operation, affordability, non‐invasiveness, and capable of dynamic and high repeatability. Compared to other imaging examinations, it can provide more evidence for the diagnosis of ICA absence, and is suitable for widespread application and promotion.

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Agenesis of the internal carotid artery: Color Doppler, CT, and MR angiography findings

Cited by 16 publications

References 3 publications

An Important Clue in the Sonographic Diagnosis of Internal Carotid Artery Agenesis: Ipsilateral Common Carotid Artery Hypoplasia

An Important Clue in the Sonographic Diagnosis of Internal Carotid Artery Agenesis: Ipsilateral Common Carotid Artery Hypoplasia

Hypoplasia of the internal carotid artery: a noninvasive diagnosis

Application and diagnostic points of carotid artery ultrasound in the detection of internal carotid artery absence: Analysis of 16 cases and literature review

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